[Sociological problems in the health status and health behavior].
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Adult↗
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Results for “Health Status”
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Monitoring health status, access to health care, and compliance behavior in a large urban community: a report from the Los Angeles health survey.
This article summarizes results from 2 health surveys conducted in Los Angeles County in 1974 and 1977. The original objective of this analysis was to identify aggregate changes in the health status of this population, in access as measured by the use/disability ratio, and in self-reported compliance with medical regimens. Additionally, we have suggested that this study illustrates the value of local population surveys for health policy--particularly in regard to recent Health Systems Agencies legislation. Substantial correspondence was found between the health status characteristics of both samples and national estimates, particularly for the prevalence of chronic illness. We also found a 3-year trend of increasing disability that is consisted with national data. However, unlike the national estimates, we found evidence of improved access relative to disability, and a corresponding reduction in the traditional income differential. Analysis of self-reported compliance showed little change over time, with Anglos and the middle and upper socioeconomic groups reporting less compliance with their doctors' recommendations.
Adolescent↗
['Public health status and perspectives' 1997. II. Developments in health status].
As a part of the report 'Public health status and forecasts' 1997 recent developments in the health status of the Dutch population and its determinants are described. Developments until the year 2015 are forecast on the basis of expected demographic and epidemiologic trends, according to expert opinions. Important findings are the unfavourable trends in lifestyle factors in adolescents and the expected increase by 25-60% in 2015 of the prevalence of diseases of old age like cancer, cardiovascular diseases, diabetes mellitus, dementia, chronic nonspecific lung diseases, visual and hearing impairments and diseases of the locomotor system.
Adolescent↗
Health status and national health priorities.
Various measures of the health status of the population of the United States show there is considerable room for improvement. Compared with other industrialized nations, we are spending more for health care but our health is worse. These data form the basis for setting national priorities. Four selected policy issues are discussed, including access to medical care, maternal and child health care, the acquired immunodeficiency syndrome, and long-term care. Examination of these issues leads to the conclusion that universal and affordable health care is the major national health priority, requiring a commitment by the people of the United States and its leaders to develop a viable solution.
Female↗
Curative medicine, preventive medicine and health status: the influence of politics on health status in a rural Mexican village.
This paper examines a recent program which purports to address the health concerns of millions of poor rural Mexicans whose constitutional guarantees of health have been largely ignored. This new program asserts the importance of preventive medicine, but makes little effort to implement preventive measures. The curative medicine it does emphasize in practice may alleviate pain and suffering for a time, but ignores critical factors that contribute to the persistence of disease. This paper examines why underdeveloped countries are more likely to implement curative than preventive services for poor people, even while proclaiming the importance of preventive measures. In dependent capitalist economies, the rural penetration of state-directed health services perpetuates the privileged position of the political and economic elite. Based on research conducted in a highland Chinantec village in Oaxaca, this paper concludes that the recent health services program addresses symptoms rather than causes of disease and is not likely to significantly improve the health status of the people who are most in need of such assistance.
Delivery of Health Care↗
Health status and satisfaction with health care: a longitudinal study among patients served by the Veterans Health Administration.
As the Veterans Health Administration (VHA) places high priority on becoming a performance-based organization, there is an increasing need to quantify and refine its outcome measurement system. Using panel data from VHA ambulatory care patients (1996-1998), we conducted cross-lagged correlations and ordinary least squares regression to examine the relationship between 2 VHA health care values: health status and satisfaction with care. The study results indicated that patients' health status was significantly associated with their satisfaction with care, indicating that patients with better health status were more likely to be satisfied with health care. Although satisfaction with care was both a consequence and a determinant of health status, the effects of health status on satisfaction seemed to be more important than the effects of satisfaction on health status. More research is needed for a better understanding of the dynamic relationship between health status and satisfaction with care.
Adult↗
Health status of illiterate adults: relation between literacy and health status among persons with low literacy skills.
BACKGROUND: In nonindustrialized nations, illiteracy is independently associated with poor health. The objective of this research was to determine whether such a relation exists in the United States. METHODS: One hundred ninety-three persons were randomly selected from a group of adult students enrolled in a publicly funded literacy training program. Subjects' health status was measured with the Sickness Impact Profile (SIP), a behaviorally based measure of sickness-related dysfunction. Subjects' literacy skills were also measured. Multivariate statistical techniques were then used to evaluate the relation between health status and literacy level and to adjust for confounding sociodemographic factors. RESULTS: The physical health (measured by the SIP) of subjects with extremely low reading levels was poor compared with that of subjects with higher reading levels. The relation between reading level and physical health was statistically significant (P less than 0.002), even after adjusting for confounding sociodemographic variables. Psychosocial health (measured by the SIP) was poor across all levels of reading skills and was comparable with the psychosocial health of populations with severe psychosocial disability. The relation between reading level and psychosocial health was statistically significant (P less than 0.02) after adjusting for confounding variables. CONCLUSIONS: In the United States, illiteracy and poor health status are independently associated.
Adolescent↗
A 1993 Status Report on the Health Status of Asian Pacific Islander Americans: Comparisons with Healthy People 2000 Objectives.
PURPOSE OF THE PAPER: The purpose of this paper is to offer a current assessment of the health status of Asian Pacific Islander Americans (APIAs) with respect to relevant Healthy People 2000 objectives and an assessment of Federal resource allocations targeted at APIAs. SUMMARY OF METHODS UTILIZED: The author reviewed documents from the relevant progress reports made to the Assistant Secretary on Health on Healthy People 2000 objectives, other Federal documents, and a review of the literature. PRINCIPAL FINDINGS: Adequate progress has been made on only one of the eight objectives targeted at APIAs; progress on the remaining objectives is either "not on target," require more data to evaluate, or inappropriate for APIAs at this time. Examples of APIA health problems not included in Healthy People 2000 objectives were documented. Illustrations of inadequate allocations of Federal health resources were cited. CONCLUSIONS: APIAs have been among the most neglected minority group with regards to health status surveillance, health services, and have been the most overlooked in Federal resource allocations. However, as greater awareness of data deficits and health status is presented, policy makers have the opportunity to improve the situation. A policy to improve the health status of APIAs must be multifaceted and minimally include the facets of data needs, intervention approaches, a research agenda, and advocacy. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: A 1993 review of the health status of APIAs with regards to the eight Healthy People 2000 and areas not covered by Healthy People 2000 were reviewed. KEY WORDS: Asian Americans, health status, health policy, health planning, tobacco, diet, diseases
Journal Article↗
Evaluation of health status and health-related quality of life in a cohort of Italian children following treatment for a primary brain tumor.
BACKGROUND: This study is a pilot experience aiming to investigate the compliance of an institutional cohort of Italian children treated for a malignant disease and their families in completing the health utilities index2, (HUI2) and the effectiveness of this measured in terms of their health status (HS) and health-related quality of life (HRQL). It specifically, it aimed to compare the HS and the HRQL, as expressed by the HUI2 global utility score, in cohorts of patients who had brain tumors, extra-cerebral solid tumors, or leukemia/lymphoma. PROCEDURE: Fifty survivors of brain tumors, between 8 and 30 years at the time of the assessment ("self") and/or their parents ("proxy"), attending the Pediatric Oncology Out Patient clinic of Padua, Italy, completed the HUI2 questionnaire. Eighty-nine children with acute leukemia/lymphoma and 74 with extra-cerebral solid tumors and/or their parents were also assessed. RESULTS: The mean "self" and "proxy" HUI2 global utility scores in the brain tumor patients were 0.87 and 0.84, respectively, while in the cohorts of children with other solid tumors and leukemia/lymphoma, there were 0.94, 0.91, 0.96, and 0.92, respectively. The differences between the HUI2 global utility scores in the "self" and "proxy" assessment within each cohort of children were not statistically significant. In decreasing order of frequency, the attributes affected most commonly were: "emotion," "pain," "sensation," and "cognition" both by "self" and "proxy" assessment. CONCLUSIONS: In this Italian population of childhood cancer survivors the HUI2 questionnaire proved to be a user-friendly tool, which provided information regarding HS and HRQL. A larger cohort of cancer children is needed to confirm the efficacy of the HUI2 questionnaire in distinguishing groups of children on this basis by disease category.
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[Program for improving health status of growing-age population in the light of the report on the health status and health care of the growing-age population and the action program for the years 1975--1990].
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Adolescent↗
Validation of health status instruments.
Health status instruments are questionnaires that are utilized to assess changes in health status of individuals. These surveys are increasingly of importance as health care providers are challenged to justify treatment approach and rationale. Objective criteria (e.g. CT scan of the sinuses) can be used to determine whether there is clinical evidence of disease. However, the impact of the disease on the individual's life is not included in such a clinical assessment. The use of validated and reliable health instruments is directed at measuring this impact in a reproducible and valid fashion. In patient-centered research, 'experimental' conditions are constantly changing because we are dealing with human beings with values, feelings, and perspectives. It is especially important to use valid measurement tools when assessing these impacts. This article outlines the principles of the development and validation of health status instruments and offers examples of such instruments from the otolaryngology literature.
Health Status↗
The influence of socioeconomic status on change in health status after hospitalization.
We reviewed patients' hospital records and surveyed patients after hospital discharge to determine whether the experience of being hospitalized differentially affected the health status of persons with different socioeconomic backgrounds (as measured by income level and education level) and to determine whether the association between socioeconomic status (SES) and change in health status varied depending upon the reason for hospital admission. We studied patients admitted to six university-affiliated teaching hospitals in Massachusetts and California for chest pain (N = 797) and surgery (N = 1165). We compared the health status scores of patients for a variety of outcomes: basic activities of daily living, instrumental activities of daily living, social activities, mental well-being, work performance and housework performance. Lower-SES patients entered the hospital with worse health status than higher-SES patients. Change in health status, statistically adjusted for case-mix, varied by reason for admission. Patients with chest pain generally reported either no improvement or a decline in functioning with the amount of decline equivalent for low- and high-SES patients. Surgical patients reported improvement in functioning following hospitalization. For several measures, lower-income surgical patients reported greater improvement than did higher-income patients, but still did not reach the same level of health status as higher-income patients.
Activities of Daily Living↗
Health status and health-related quality of life in long-term adult survivors of pediatric solid tumors.
We have examined the influence of selected factors (gender, marital status, socio-economic status, co-morbid conditions, access to medical care, age at diagnosis, intensity of therapy and time since diagnosis) on subsequent health status and health-related quality of life (HRQL) of long-term survivors of pediatric solid tumors. Two hundred and twenty individuals who had survived a pediatric solid tumor 15 years or longer completed telephone and written assessments of their current status. Health status was assessed using the Late Effects of Normal Tissues toxicity scale. HRQL was investigated using the Ferrans and Powers Quality of Life Index-Cancer (QLIC) and the EORTC Quality of Life Questionnaire C30 (QLQ-C30). Results indicated that health status and HRQL were better in survivors treated with low-intensity therapy. One hundred and thirty respondents (59.1%) reported at least 1 serious toxicity. Dyspnea and fatigue were commonly reported in survivors of Hodgkin's disease. Correlational analyses showed that predictors of health status included socio-economic status, marital status and the presence of co-morbid factors. Mean HRQL scores for the 4 domains of the Ferrans and Powers QLIC and the functional scales of the EORTC QLQ-C30 indicated that most of the survivors were experiencing moderately good to excellent HRQL. One-third of survivors reported that their history of cancer had an adverse impact on their current financial status. Prediction models constructed for 3 of the domains from the 2 HRQL instruments are presented (health and functioning, global HRQL and financial impact). Within these 3 models, consistent predictors of HRQL outcomes included health status, presence of dyspnea or pain, marital status and socio-economic status.
Adult↗
Why call it health-related quality of life when you mean perceived health status?
Health-related quality of life is a term frequently used in health services and nursing research. However, when using this term, researchers often refer to the self-perceived health status or the functional abilities of the patients. Since there is increasing evidence that quality of life and health status are distinct concepts, the appropriateness of the term 'health-related quality of life' is questionable. Therefore, researchers should consider whether health-related quality of life is actually measured if a health-status instrument is used. The scientific community should take up this conceptual discussion in order to make the concept of quality of life less ambiguous.
Cardiovascular Diseases↗
Developing appropriate dental education systems: the impact of changes in oral health status and oral health care systems.
Current education programmes for oral health care workers have failed to adapt to the changing oral health status and the changing demands made upon oral health care systems. In order to adapt, education systems need to recognise the forces that are influencing the demands on the oral health care system and identify the most appropriate solutions. The most logical solution is to develop programmes which reflect the Primary Health Care Approach (PHCA), and in particular emphasise inter-sectorial collaboration. The challenge for dental education systems is to identify mechanisms through which these principles can be applied.
Clinical Competence↗
Responsiveness of health status instruments to changes in articular status and perceived health in patients with psoriatic arthritis.
OBJECTIVE: To compare the responsiveness of the Health Assessment Questionnaire (HAQ), Arthritis Impact Measurement Scale 2 (AIMS2), and Medical Outcome Study Short Form Health Survey (SF-36) to changes in articular status and perceived health in outpatients with psoriatic arthritis (PsA). METHODS: The 3 health status instruments were administered in random order on 2 occasions, about 12-18 months apart, to 70 patients attending the University of Toronto psoriatic arthritis clinic. Standardized assessments of disease activity, disease severity, and general health perceptions were also performed at each clinic visit. To assess responsiveness we used: (1) linear regression analyses to relate change scores for perceived health, the number of actively inflamed, and damaged joints to change scores for selected dimensions of the HAQ, AIMS2, and SF-36; (2) logistic regression analyses to relate both improvement in disease activity and disease progression to health status change scores; and (3) standardized response means (SRM). RESULTS: There were 43 men and 27 women with a mean age of 46 years and arthritis duration of 13 years. Univariate regression analyses showed that the individual instruments were responsive to perceived changes in health, but relatively insensitive to detect changes in articular status. Multivariate regression analyses, in which the common dimensions of the instruments were jointly entered, indicated the SF-36 was equally or more responsive to changes in number of actively inflamed joints, clinical improvement in disease activity, and perceived health than the HAQ and AIMS2. The SRM analysis also suggested that the SF-36 was the most responsive. CONCLUSION: The SF-36 proved equally or more responsive to short term changes in perceived health and inflammatory disease activity; however, none of the instruments showed responsiveness to disease progression.
Adult↗
The role of race/ethnicity and social class in minority health status.
Minority health is often considered as a unitary phenomenon; it is often assumed that the health status of minority groups in the United States is similar across groups and much worse than that for whites. Yet the reality is extraordinary diversity. Racial/ethnic groups differ greatly both among and within themselves with regard to health status and with regard to a large number of other indices. Mortality rates around the world generally show an inverse relationship with social class. While this generally holds true in the United States as well, once again we see a strong interaction with race/ethnicity. However, the mediating factors between race/ethnicity and social class, and health status are not well understood. Especially in the face of health care reform, a broad-based research agenda needs to be undertaken so that any restructuring of the health care delivery system is informed by empirical information.
Adolescent↗
Social contact, socioeconomic status, and the health status of older Malaysians.
We tested the applicability of the stress buffering hypothesis in a developing country setting with data from the Senior Sample of the Malaysian Family Life Survey-2. Using ordered logistic regression methods, we examined whether having daily contact with adult children moderates the effect of low socioeconomic status (SES; conceptualized as a chronic stressor) on self-assessed health status. We found that low SES is associated with poorer health for all three ethnic groups--Malay, Chinese, and Indian. Further, for Malays and Chinese, we found that the negative effects of low SES on health tend to be stronger for older people with less frequent contact with adult children than for those who have daily contact. These results provide general support for the buffering model and suggest that, as found in developed countries, active intergenerational relationships in developing country settings may have protective effects on the health of older people experiencing chronic stressors.
Adult↗